According to the National Alliance for Caregiving, the number of adult individuals in the United States providing care for patients with cancer ranges between 2.8 million and 6.1 million. Caregivers for patients with cancer who live more than 1 hour away report having higher levels of anxiety and distress than local caregivers, often due to a lack of firsthand information and uncertainty regarding the patient’s health status.
The use of a coaching videoconference intervention significantly reduced levels of anxiety and distress among “distance caregivers,” according to the results from a randomized controlled trial by Douglas et al. The study was presented in a press briefing prior to the ASCO20 Virtual Scientific Program (Abstract 12123).
Photo credit: Getty
Study Methodology
The researchers conducted a randomized controlled trial at a large urban comprehensive cancer center. Between November 2016 and October 2019, they enrolled 441 distance caregivers who lived more than 1 hour from the patient with cancer they were treating. Patients with all cancer types were eligible if they had monthly appointments with their oncologist and were receiving treatment. The distance caregivers were randomly assigned to one of three arms:
- Participants in arm 1 received four monthly videoconference coaching sessions with a nurse practitioner or social worker, which focused on providing information and support. The caregivers participated in a patient’s appointments with the oncologist via videoconference and had access to a website designed for distance caregivers.
- Caregivers in arm 2 did not receive the coaching sessions but did participate in the virtual patient-oncologist visits and had access to the same website.
- Caregivers in arm 3 had access to the website only.
The average age of the distance caregivers was 47 years; 71% were female; and 63% of the caregivers were children of the patient. The average age of the patients was 65 years; 60% were female; and 30% and 18% of the patients had gastrointestinal and hematologic cancers, respectively. Of the patients with solid tumors, 59% had stage IV cancer.
Primary variables of interest were distance caregiving distress and anxiety. Participants completed online surveys prior to randomizations and at the completion of the intervention period. The PROMIS Anxiety scale and the National Comprehensive Cancer Network® Distress Thermometer and Problem List for Patients were used to measure levels of anxiety and distress.
Repeated measures of ANOVA were used to examine the change in anxiety t-scores over time by arms of the intervention, controlling for distance caregiving age, race, and sex.
Study Results
The researchers found that there was significant anxiety by group interaction (P = .03), with arm 1 being the only group that showed a significant reduction in anxiety over time (21.2% improved, effect size = .57). Distress followed a similar pattern with a significant distress by group interaction (P = .02) with participants in arm 1 demonstrating the greatest improvement in distress over time (54.3%).
“These data suggest that the use of a coaching videoconference intervention made significant and clinically meaningful differences in anxiety and distress for these important members of the family caregiving team,” concluded the study authors.
Clinical Significance
Providing virtual support for distance caregivers can have significant impact on their emotional well-being, especially during the COVID-19 pandemic, when social distancing practices make it even more difficult for distance caregivers to participate in their loved one’s care.
Howard A. “Skip” Burris III, MD, FACP, FASCO
“As COVID-19 forces separation from loved ones and increases anxiety for people with cancer and their caregivers, providing emotional support virtually is more important than ever,” said ASCO President Howard A. “Skip” Burris III, MD, FACP, FASCO, in a statement. “This study shows how effective videoconferencing interventions can be in improving the emotional well-being of remote caregivers, who in turn provide critical support for patients.”
Disclosure: Funding for this study was provided by the National Institutes of Health.
